[Right ileocolonic intubation after resection of the terminal ileum for generalized peritonitis caused by ileal perforation. An African experience with 33 cases].
Generalized peritonitis due to ileal perforation is common in Africa, and is caused by typhoid fever in most cases. For various reasons, the patients arrive at hospital in a poor general condition. In spite of combined intensive care and surgery, the general evolution of the disease resulted in a high mortality rate. All surgical techniques requiring sutures on a poor-quality ileon, ie. excision and suture, limited segmental resection or extensive ileal resection, most often lead to the breakdown of suture lines, so that the patient enters the vicious circle of repeated peritonitis and hazardous re-operations. Even exteriorized suture lines turn into fistulae, and temporary terminal ileostomy requires an amount of maintenance that is sometimes difficult to ensure in Africa. The technique proposed by the authors was developed in the department of surgery of the Dakar Main Hospital and has several advantages: It is a simple and quick procedure, which does not require the surgeon to be very experienced and can be performed in underequipped hospitals. There is no procedure-associated mortality. Morbidity decreases as the surgeon's experience increases. GI continuity can be established even in a septic environment. No second-look operation is necessary, so that the stay at hospital becomes shorter and the costs of treatment lower. Lastly, this type of restoration can be applied to other indications such as right colectomy and ileocolic or transverse ileal intubation.
Ribault
L
L
Services chirurgicaux, Hôpital Principal, Dakar, Sénégal.
Veillard
J M
JM
Sarre
B
B
Diouf
B
B
Bellier
L
L
Diagne
A L
AL
D000293:Adolescent; D000328:Adult; D002648:Child; D002675:Child, Preschool; D004630:Emergencies; D005260:Female; D006801:Humans; D007082:Ileum / Q000601:surgery; D007416:Intestinal Perforation / Q000150:complications / Q000601:surgery* / Q000628:therapy; D007441:Intubation, Gastrointestinal / Q000379:methods*; D008297:Male; D010538:Peritonitis / Q000209:etiology / Q000601:surgery* / Q000628:therapy; D012675:Senegal
Intubation iléo-colique droite après résection de l'iléon terminal pour péritonite généralisée par perforation iléale. Expérience africaine de 33 cas.